Case Manager, RN

Job not on LinkedIn

🔥 4 minutes ago

🏈 Ohio – Remote

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💵 $54.1k - $129.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 0%

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Logo of CVS Health

CVS Health

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• Assess members’ health status and care coordination needs • Conduct inpatient review and discharge planning • Develop, implement, monitor, and evaluate case management plans • Involve the Medical Director as indicated and close cases when discharge criteria are met • Identify members using data-driven methods for individualized case management programs or alternative healthcare referrals • Conduct comprehensive clinical assessments • Evaluate needs and develop approaches based on member needs, benefit plans, or external programs and services • Advocate for patients within existing healthcare coverage • Promote quality, cost-effective outcomes and suggest program or operational efficiency improvements • Identify and escalate quality-of-care issues • Provide a high level of customer service • Assess health literacy, technology capabilities, and readiness to change • Use influencing and motivational interviewing to engage members and promote lifestyle or behavior changes • Provide coaching, information, education, and support to empower independent medical and healthy lifestyle choices

🎯 Requirements

• Active, current, and unrestricted RN license in state of residence • Willingness and ability to obtain additional state licenses upon hire • 3+ years of acute care experience as an RN • Willingness and ability to work Monday through Friday, 8:00am–4:30pm in time zone of residence, with an occasional late shift rotation of 11:00am–8:00pm EST once per quarter • Associate Degree required • Compact RN License or multistate licensure preferred • Certified Case Manager (CCM) preferred • Managed Care experience preferred • Hospital experience in ICU, CCU, Step Down, ER or OR preferred • Telephonic case management and/or telephonic experience preferred • Direct/hardwired internet connection to modem/router within 7 feet of computer • Minimum internet speed of 25 Mbps download and 3 Mbps upload • WiFi and satellite internet are not permitted • Quiet, secure, private designated home work location compliant with CVS Health and HIPAA guidelines • Must work within the state and city where currently living • Must provide own workspace furniture • Ability to use multiple monitors and navigate multiple applications simultaneously • Ability to communicate via email, calendar invites, Teams messaging, and virtual meetings • Experience with Microsoft Office 365 applications or similar Google Workspace applications • Ability to access secure systems such as VPN and EHR portals • Ability to follow computer security and password practices and recognize suspicious emails or links • Ability to troubleshoot common technical issues independently

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program in addition to base pay • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being • Company-provided equipment (keyboard, monitor, computer, headset, etc.) • Additional state licenses paid for by the company

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